A TherapyNotes alternative for cash-pay practices

TherapyNotes is behavioral-health EHR software with built-in claim filing, priced per clinician. MegAligna is an alternative for practices that bill through their own biller or run cash-pay: SOAP, DAP and BIRP notes, treatment plans, superbill and CMS-1500 exports, and free seats for admin and billing staff.

Who this comparison is for

TherapyNotes files claims and MegAligna does not. A practice billing in-network through its EHR today, and satisfied with that workflow, has no reason to move.

This comparison is for the other two kinds of practice: those whose billing already sits with a dedicated biller, and cash-pay or out-of-network practices that pay for a claims pipeline they never use.

TherapyNotes vs MegAligna: feature comparison

Public vendor information as of July 2026, pending re-verification. Rows where TherapyNotes is ahead are included.

	MegAligna	TherapyNotes per clinician
In-app claim filing and payer enrollment ¹	No	Yes
Free seats for admin, front desk and billers	Yes	No
SOAP, DAP and BIRP templates with treatment plans ³	Partial	Yes
Authorization unit tracking with warnings at booking	Yes	Partial
Published price	Yes	Yes

¹ TherapyNotes' core capability. MegAligna exports superbills and CMS-1500 PDFs for your biller to submit, which is a different billing model rather than an equivalent one.
³ Treatment plans linked to notes are shipped here, and TherapyNotes is strong on both. The difference is the templates: TherapyNotes gives you the three named formats ready-made, while here you build the layout from your own fields.

How TherapyNotes pricing compares at group size

Per-clinician pricing with claim filing charged on top fits a solo practice cleanly. A group with intake coordinators, a front desk and an outside biller pays per-clinician rates for staff who never write a note.

Non-clinical seats are free in MegAligna, so the same group pays for its clinicians only, and the biller’s login — the person the export model exists to serve — costs nothing.

When it comes to the move, switching from TherapyNotes covers what the importer accepts, what happens to historical notes and treatment plans, and the order to cut over in.

Common questions

Can notes and treatment plans migrate from TherapyNotes?

Demographics and appointments import via CSV; historical notes and plans arrive as attached documents rather than structured data. Export a complete record set while the account is active.

We use TherapyNotes with an outside biller anyway — what changes?

That arrangement is exactly the mismatch this page describes: you are paying for an in-app claims pipeline while your biller works from exports. Here the export is the product — per-session CSV and CMS-1500 PDFs in the format your biller asks for, from a free biller seat.

Do you handle telehealth appointments?

Sessions schedule and bill as telehealth with the correct place of service and modifier. No video is embedded, so the practice brings its own HIPAA-covered video platform under its own business associate agreement.

Try it end to end with test data

14 days, no card required. Use made-up patients while you evaluate — real patient information waits until a business associate agreement is in place.

Start a 14-day free trial See the behavioral health pages